Provider Demographics
NPI:1740294172
Name:SOLARES, ANDREW M (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:SOLARES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 S CLIFF AVE
Mailing Address - Street 2:EMERGENCY STE
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1007
Mailing Address - Country:US
Mailing Address - Phone:605-322-2000
Mailing Address - Fax:
Practice Address - Street 1:1325 S CLIFF AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1007
Practice Address - Country:US
Practice Address - Phone:605-322-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5470207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE46022474331Medicaid
MN507414200Medicaid
IA0584797Medicaid
SD5470OtherDAKOTACARE
MN322K3SOOtherMN BC PROVIDER #
SD6631040Medicaid
FL001837700Medicaid
SD0042413OtherBLUE CROSS OF SD
NE46022474331Medicaid
FL001837700Medicaid
SD6631040Medicaid
MN507414200Medicaid